Abstract
Flexible gastro-intestinal (GI) endoscopy is an integral diagnostic and therapeutic tool in clinical gastroenterology. High quality standards for safety, patients' comfort, and efficiency have already been achieved. Clinical challenges and technical approaches are discussed in this short review.Image enhanced endoscopy for further characterization of mucosal and vascular patterns includes dye-spray or virtual chromoendoscopy. For confocal laser endoscopy, endocytoscopy, and autofluorescence clinical value has not yet been finally evaluated. An extended viewing field provided by additional cameras in new endoscopes can augment detection of polyps behind folds. Attachable caps, flaps, or balloons can be used to flatten colonic folds for better visualization and stable position.Variable stiffness endoscopes, radiation-free visualization of endoscope position, and different overtube devices help reducing painful loop formation in clinical routine. Computer assisted and super flexible self-propelled colonoscopes for painless sedation-free endoscopy need further research. Single-use devices might minimize the risk of infection transmission in the future.Various exchangeable accessories are available for resection, dissection, tunneling, hemostasis, treatment of stenosis and closure of defects, including dedicated suturing devices. Multiple arm flexible devices controlled via robotic platforms for complex intraluminal and transmural endoscopic procedures require further improvement.
Highlights
Flexible GI endoscopy is a major diagnostic and therapeutic tool in clinical gastroenterology
Light is transmitted from the connected processor to the endoscope tip from where a chip sends back image signals from the lens to a monitor
high definition (HD) endoscopy is recommended for routine colorectal cancer (CRC) screening, and real or virtual chromoendoscopy of the entire colon in high risk situations as surveillance of long standing ulcerative colitis or polyposis syndromes [16]
Summary
Flexible GI endoscopy is a major diagnostic and therapeutic tool in clinical gastroenterology. Screening for colorectal cancer (CRC), one of the three most common types of cancer worldwide, is one of the major indications for flexible GI endoscopy [3] which outperforms other methods as fecal occult blood test, fecal DNA testing, computed tomography, magnetic resonance tomography, colon capsule endoscopy, or serum based tests [4]. KeuchelComputational and Structural Biotechnology Journal 15 (2017) 168–179 infection prevention, and improvements in therapeutic endoscopy. This short review discusses clinical needs and technical solutions already achieved or under development (Table 1), addressing both engineers and clinicians. HD endoscopy is recommended for routine CRC screening, and real or virtual chromoendoscopy of the entire colon in high risk situations as surveillance of long standing ulcerative colitis or polyposis syndromes [16].
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